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General NPI Number Information
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NPI Number | 1063316784
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Entity Type | Organization
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Legal Business Name | DIVERSE RX, LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 8040 NW 95TH ST STE 228
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2361
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Country | US
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Telephone | 786-238-7656
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Fax |
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Provider Business Mailing Address
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Address Line | 8040 NW 95TH ST STE 228
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2361
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Country | US
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Telephone | 786-238-7656
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Fax | 786-238-7725
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Authorized Official
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Title or Position | OFFICER/OWNER
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Name | LEYSI MERCEDES SANCHEZ
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Credential |
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Telephone | 786-238-7656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | NULL
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